Measles mumps and rubella vaccine

Measles, mumps, and rubella vaccine (MMR). The second dose of MMR is recommended routinely at age 4-6 years but may be administered during any visit, provided at least 4 weeks have elapsed since the first dose and that both doses are administered beginning at or after age 12 months. Those who have not previously received the second dose should complete the schedule by the 11-12-year-old visit. 

The single-component viral vaccines are listed in Table 15.2 with notes similar to those provided with the bacterial vaccines. The only eombined viral vaeeine that is widely used is the measles, mumps and rubella vaccine (MMR Vac). In a sense, however, both the inactivated (Salk) poliovaccine (PoWac (inactivated)) and the live (Sabin) poliovaccine (PolWac (oral)) are combined vaccines in that they are both mixtures of vims of each of the three serotypes of poliovims. Influenza vaeeines, too, are eombined vaccines in that many contain components fiom as many as three vims strains, usually fiom two strains of influenza A and one strain of influenza B. 

Notes Measles, mumps and rubella vaccines are generally administered in the form of a combined measles/mumps/rubella vaccine (MMR vaccine). 

Measles, mumps, and rubella vaccines are available as single component vaccines or as combinations. Most authorities recommend use of the measles, mumps, and rubella combination vaccine and discourage use of the single- or double-component vaccines. Two doses of the measles, mumps, and rubella vaccine are recommended for all individuals born after 1957. The first dose should be administered soon after the first birthday and the second prior to entering school. For high-risk adolescents and adults who do not have adequate immunity, two doses of the vaccine should be separated by a minimum of 28 days.8... 

Measles, mumps, and rubella vaccine is a live virus vaccine that should be used with caution in immunosuppressed children, such as those with cancer receiving chemotherapy, solid organ or bone marrow transplantation, or receiving other immunosuppressive drugs, such as steroids in a dose... 

Varicella vaccine should be administered after 12 months of age and a second dose at 4 years of age. Adolescents and adults without evidence of immunity to varicella zoster should receive two doses of varicella vaccine given 4 to 8 weeks apart. Varicella vaccine is available as a single-component vaccine or in combination with measles, mumps, and rubella vaccine. 

Table 13.6 Some traditional vaccine preparations that find medical application. In addition to being marketed individually, a number of such products are also marketed as combination vaccines. Examples include diphtheria, tetanus and pertussis vaccines and measles, mumps and rubella vaccines...

Many of the more prominent vaccine preparations in current medical use consist of attenuated viral particles (Table 13.6). Mumps vaccines consist of live attenuated strains of Paramyxovirus parotitidis. In many world regions, it is used routinely to vaccinate children, often a part of a combined measles, mumps and rubella vaccine. 

Measles, mumps, and rubella vaccine (MMR). (Minimum age 12 months)... 

Kelso, J. M., Jones, R. T., and Yunginger, J. W. 1993. Anaphylaxis to measles, mumps, and rubella vaccine mediated by IgE to gelatin. J Allergy Clin Immunol 91(4) 867-872. 

In the United States, mumps has been on the decline since the introduction of the mumps vaccine in 1967 and again in 1977 when it was recommended for routine use. In 1989 the two-dose MMR (measles, mumps, and rubella) vaccine schedule was recommended for measles control and mumps cases continued to drop. By 2001, there were less than 300 cases annually, a 99% decline in reported cases compared to 1968 (CDC, 2006d). 

Samo, M.J. Blase, E. Galindo, N. Ramirez, R. Schirmer, C.L. Trujillo-Juarez, D.E. Clinical immunogenicity of measles, mumps and rubella vaccine delivered by the Injex jet injector comparison with standard syringe injection. Pediatr. Infect. Dis. J. 2000, 19, 839-842. 

Nieminen U, Peltola H, Syqala MT, Makipemaa A, Kekomaki R. Acute thrombocytopenic purpura following measles, mumps and rubella vaccination. A report on 23 patients. Acta Paediatr 1993 82(3) 267-70. 

Miller E, Goldacre M, Pugh S, Colville A, Farrington P, Flower A, Nash J, MacFarlane L, Tettmar R. Risk of aseptic meningitis after measles, mumps, and rubella vaccine in UK children. Lancet 1993 341(8851) 979-82. 

---